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In order to determine the eligibility of ___________________________________________ for public assistance, please assist us by answering the questions below and returning this form to us by __________________________ . Office Address / Phone Number:
- Income Verification Request
Section I: AGENCY REQUEST. The above named individual has...
- Economic Self Sufficiency Forms
Individuals can also make changes, apply for additional...
- Income Verification Request
Section I: AGENCY REQUEST. The above named individual has applied for assistance from the State of Florida. In order to determine eligibility, the department must have verification of all income and resources. Please complete Section II.
Individuals can also make changes, apply for additional assistance, check case status and more using the MyACCESS Portal. If you are unable to apply online and need a paper application, please use the forms below.
MyACCESS is a portal where Floridians can get and manage benefits online. This includes food assistance (SNAP) formerly food stamps, cash aid (TCA), and affordable health coverage (Medicaid) State of Florida Official Website
Search Florida Department of Children and Families forms by Form Number, Form Title, Form Category, or any combination of these. Some forms require Adobe Acrobat Reader, Microsoft Word, or Microsoft Excel to open, fill in and/or print.
Here you can apply for Medicaid, Food Assistance (SNAP), Temporary Cash Assistance (TCA), Optional State Supplementation (OSS), and more. Ready? Let's do this.
Glades, Charlotte and Collier counties who require Medicaid, Food Stamp, and temporary cash assistance through the FLORIDA Automated Community Connection to Economic Self Sufficiency (ACCESS) system.
